In-Vitro Fertilisation (IVF)
What is in vitro fertilization (IVF)?
In vitro fertilisation(IVF) is a form of assisted reproduction. This revolutionary combination of medicine and technology has helped create millions of healthy babies since the late 1970s.
What are the indications for IVF?
The most common indications for patients requiring IVF include:
- Infertility, including:
- Unexplained infertility
- damaged or blocked fallopian tubes
- ovulatory disorders
- poor sperm quality
- obstruction of sperm production
- Genetic issues: both eggs and sperm can carry genetic conditions that cause infertility or miscarriage. They may also be carriers of a genetic disorder and by offering IVF treatments, we can potentially test embryos and help couples avoid passing on the disorder to their offspring.
- Fertility preservation: it is common for patients to require egg or sperm freezing prior to chemotherapy, radiotherapy, surgery, gender affirmation or other treatments that may potentially cause loss of fertility.
What is involved in the IVF process?
The basic steps involved in your IVF plan are:
- Medical review with Dr Andreadis
- Nursing review by nurses: If necessary, review by a counselor, geneticist or scientist
- Ovarian stimulation:
- Daily Injection: to boost follicle (egg) development. There may be more than one type of injection. There are also different types of stimulation protocols
- Ultrasounds and blood test: to monitor the response to treatment
- Trigger injection: to help the eggs mature prior to egg collection
- Egg retrieval: removal of eggs from ovaries using a vaginal probe under ultrasound guidance. I perform all egg collections with an anaesthetic doctor present. The anaesthetist ensures patients are provided with adequate medication to be as comfortable as possible in a safe environment.
- Sperm collection: occurs as soon as eggs are obtained
- Insemination: eggs and sperm are brought together in the laboratory on the day they are collected. This can be with routine IVF or ICSI (where the sperm is directly injected into the egg).
- Fertilisation check: occurs the next day. Scientists check how many eggs have been fertilised.
- Embryo culture: embryos are nourished in the lab. The aim is to see which embryo stands out as the best and to then transfer this embryo. The remaining embryos may be frozen if suitable.
- Embryo transfer: may occur on Day 2, 3 or 5. This procedure is much like a pap smear. A speculum is inserted and the embryo inserted into the uterus with a soft catheter.
- The waiting begins: once the embryo has been transferred, it is then up to the embryo to implant. Implantation is when the embryo and endometrium form special and complex connections. If this goes well, a pregnancy then develops.
What are the risks and complications of IVF?
As with any surgical procedure, risks and complications can occur. The possible complications associated with specific steps of an IVF program include:
- risks of egg retrieval include: bleeding, infection, and damage to the bowel, bladder, or blood vessels
- ovarian hyperstimulation syndrome (OHSS): a condition of ovarian enlargement accompanied by fluid accumulation in the abdominal cavity
- ovarian torsion
- risk of multiple births
- risk of premature and low birth weight babies
- possibility of ectopic or tubal pregnancy